‘‘They Treated Me as if I Were Dead’’ 141
These doctors reveal the degree to which they, too, are aware of, and
might be influenced by, blaming patients for disease. As suggested earlier,
Stuart and others also felt doctors should somehow be held to a higher
standard—to have used their medical knowledge to alter their own be-
havior. Here again, physicians may differ from lay patients, and have more
difficulty.
Magical thinking can exacerbate difficulty accepting one’s illness. De-
spite scientific training, one doctor wondered at first if HIV was in fact a
punishment. ‘‘I can remember thinking: ‘Why me? Am I a bad person, am
I evil?’. . . I prayed the test would be negative.’’
All-too-human rationalizations can hamper optimal use of one’s own
medical knowledge. Kurt, who had used crack, felt he ‘‘deserved’’ HIV.
These doctors employed rationalizations based, too, on other aspects of
their lives. Kurt continued:
Because I’m a doctor, there is more shame. Not only should I have
known better, because I was a doctor, but I grew up in L.A. My
best friend died of AIDS at twenty-five. I’d buried many people. But
my partners were generally young. I could feel lymph nodes. I knew
what high-risk people looked like. I could see whether these guys
were in the high-risk group. It was a fucking game: Russian roulette.
Kurt made numerous assumptions (e.g., that he could visually diagnose
HIV in his partners) over many years.
Some of these physicians feared that their sense that ‘‘they should have
known better’’ would be shared by their colleagues. As will be discussed
later with regard to mechanisms of coping, such apprehensions may im-
pede obtaining care and beneficial services.
Entering and Exiting the Sick Role
These concerns about colleagues’ responses in turn molded decisions
about whether, when, how, and to what degree to enter and exit the sick
role. Ill physicians faced dilemmas not only about adopting this role, but
also about relinquishing it. The sociologist Talcott Parsons and others have
written extensively about entrance into this position, but much less about
decisions on when, how, and to what degree to leave it—who does or does
not do so.